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i Form~'.~oue RECEIP7 FOR INHERITANCE AND ESTATE TAX RAY E. GREEN, Comptrollar !ry ,
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~,£q,s~ STATE OF FLORID,~ ,
~ TALLAHASSEE 0 E. T. ~
~M~, N, is176
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• Re~ E~tat~ of~
~ ~ C arles Hurwitz Robert Lincoln Rutherford ~ '
. ~ To Winifred June Dussault~ Florida Propetty in St. Lucie Co nty 4
t ~ The National Shawmut Bank of Massachusetts, Norfolk C unty ~
~ Admiai~br~d in ~ ~ I
~ May 25~ 1961
Executors Date of Deatkr
~ 1, AAY E, CREEN, Comptroller of the State of Florida, do ha~by ccrtiEy that 1 am the officcr of Mld Stnte hnving cuatody and ~
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~ control of thc ra~ords pcrtnining to tbc assessmcat and collection of i~hcdtana~ nnd estate tax nayublc to it; thnt thcrc hns bcen f'ilcc ,
with me a swom rctum for estate tax in the mattcr of nbovo namal I~stato and that thc amount of tax asscssed by thc State of Flurida
~ Two Hundred Twenty and 59/100 i ~
~ agaiast aaid Estatc was
~ ~ [lollars { $ ~
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~ I furthcr certlfy that tho following paymcnts hnve becn made in full settlemcnt of the estatn tax essesscd agulnst said Estatc: , I ~
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September 19, 1963 $13.42 Interest & $214.53 Tax ~ ;
~ x ' 1.20 Interest & 6.06 Tax yv
~ October 1, 1964 C~1 I
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~ r 220.59 Tax in o° '
~ ~~~o;~ $14.62 Interest & $ ,
~ p~ ~ ~ full ~ ~ ~
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It 1~ further cediEiecl th'at no refuod of aue6 tax nor any portion thcrwf has been authorized and that no clulm for r~fund thcrcoE ~ I r S
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flrtnhPr A. D, 19 ~ 1 t N~ r,
EXECUTED in quadruplicatc under my hand and acal thia the _l,_.__ day oE ~ ~0. ~h j
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